颊针疗法对肩袖修补术患者术后镇痛及康复的影响  

The effect of buccal acupuncture therapy on postoperative analgesia and rehabilitation in patients undergoing rotator cuff repair

作　　者：黄超群[1] 章钰 林佳屿 涂雅慧 庄进飞[1] 张旭彤[1] 李军[1] HUANG Chaoqun;ZHANG Yu;LIN Jiayu;TU Yahui;ZHUANG Jinfei;ZHANG Xutong;LI Jun(Department of Anesthesiology and Perioperative Medicine,the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第二医院育英儿童医院麻醉与围术期医学科,浙江温州325027

出　　处：《温州医科大学学报》2024年第3期205-210,216,共7页Journal of Wenzhou Medical University

基　　金：温州市基础性科研项目(Y2023976)。

摘　　要：目的:观察颊针疗法对肩袖修复术患者术后镇痛的有效性及康复的影响。方法:选取2021年10月至2022年6月因肩袖损伤在温州医科大学附属第二医院育英儿童医院择期行手术治疗的患者140例,性别不限,ASA分级I~III级。患者均在统一的全身麻醉复合臂丛神经阻滞下完成肩关节镜下肩袖修补术,根据术后镇痛方案随机将患者分成单纯使用患者自控静脉镇痛泵(PCIA)的对照组(A组)、颊针联合PCIA组(CA组),每组70例。比较两组患者术后6、12、18、24、48 h静息与运动VAS评分,术中及术后镇痛药用量、患者恢复质量评分(Qo R-40项评分、ADL评分、Barthel指数),术后3个月ASES评分、Constant-Murley肩关节功能评分及睡眠质量(PSQI)评分。结果:与A组相比,CA组患者术后6、12、24、48 h静息及运动VAS评分均明显降低(P<0.05),PCIA镇痛相关不良反应明显减少(21.0%vs.40.3%,P<0.05),且术后48 h Barthel指数、QoR-40项评分及满意度明显提高(P<0.05)。两组患者术后48 h镇痛药用量、ADL评分、Barthel指数及术后3个月ASES评分、Constant-Murley肩关节功能评分和PSQI评分比较,差异均无统计学意义(P>0.05)。结论:颊针疗法可增强肩袖修复术后PCIA的镇痛效果,减少镇痛不良反应,明显提高患者术后48 h恢复质量及满意度。Objective:To observe the effect of buccal acupuncture therapy on postoperative analgesia and rehabilitation in patients with rotator cuff repair.Methods:A total of 140 patients of both sexes,ASA grade IIII,who were scheduled for elective surgery due to rotator cuff injury in our hospital were selected.All patients underwent shoulder arthroscopic rotator cuff repair under unified general anesthesia combined with brachial plexus block.According to the postoperative analgesia protocol,the patients were randomly divided into control group(group A,patient-controlled intravenous analgesia pump used alone)and buccal acupuncture combined with PCIA group(group CA),with 70 cases in each group.The rest and exercise VAS scores at 6,12,24 and 48 h post-operation,analgesic consumption and quality of recovery scores(QoR-40 items,ADL score,Barthel index)within 48 h post-operation,ASES score,Constant-Murley shoulder function score and PSQI score three months after surgery were compared between the two groups.Results:Compared with group A,the rest and exercise VAS scores at 6,12,24 and 48 h post-operation were significantly decreased(P<0.05),the PCIA analgesia-related adverse reactions significantly decreased(21.0%vs.40.3%,P<0.05),and QoR-40 items,Barthel index and degree of satisfaction at 48 h were significantly increased(P<0.05).However,there were no significant differences in analgesic dosage,ADL score and Barthel index within 48 hours post-operation,sleep quality(PSQI score),Constant-Murley shoulder function score and ASES score 3 months after surgery between the two groups(P>0.05).Conclusion:Buccal acupuncture can enhance the analgesic effect of PCIA,reduce the adverse reactions to analgesia,and significantly improve the patient’s recovery quality and satisfaction of 48 h after undergoing rotator cuff repair.

关 键 词：肩关节镜 肩袖修补术 颊针 臂丛神经阻滞 患者自控静脉镇痛 康复 

分 类 号：R614[医药卫生—麻醉学]